This mission was the third in Sierra Leone.

Since commencing the project, the aims and objectives have evolved throughout this journey.

In the first trip, I was a dentist tagging along with a well established diaspora of medical professionals. By the time I arrived to commence the 2021 mission, there was a concrete plan of action. This goal had been endorsed by the chief dental officer as well as IOM.

I was entrusted to replicate what I had achieved in Moyamba 2019:

Upon arrival at the district hospital, I was allocated two adjoining rooms and two reclining chairs, procured from Connaught Hospital).

I had brought my instruments from the UK.

This included the following:

Gauze, tissues etc were provided by the hospital.

The team I was allocated were as follows.

On the first day, we saw only a few patients, as my priority was to establish the fundamentals of running a safe clinic with the limited resources at our disposal. Also, there wasn’t a high patient uptake initially, as no official announcement of the service had been made.

By the second day we were getting into the flow of things and soon we were averaging around 75 patients a day. However, there were obstacles that restricted our services, like the generators that run the autoclaves being turned on late.

Mohammed Jalloh, who was only trained up less than 3 years ago, had clearly gained a wealth of experience. He was able to carry out extractions in a safe and efficient manner, at a very impressive work rate.
In the first few days, the nurses assisted us and mainly managed the maintenance of the clinic. In the latter days they eventually moved on to administering local anaesthetic and carrying out simple extractions under supervision.

The patients we treated were mainly suffering from toothache resulting from gross tooth decay. Only a select few were suffering from mobile teeth caused by gum disease. The main teeth we extracted, were lower first molars. This was not surprising, as they are the first adult teeth to appear and are situated further back, making them less accessible to cleaning.

However, what was disturbing, was many cases had presented with pus oozing sinuses that had tracked from the oral cavity out onto the surface of the face and jaw. In a few cases, young patients had presented with bone necrosis in the jaw. This was a very sad situation, as there was no referral option, these patients futures seemed very bleak.

Following our experiences with patients that were presenting with life threatening conditions, which had originated from simple tooth decay, we decided to turn our attentions to treating children. This was in the hope that we may halt the progression of the disease.

The next couple of mornings I dedicated my time to visiting two local secondary schools. I gave a talk on prevention and promoted our services. As a result of this initiative, we had over 200 students turn up on the last two days for treatment.

It should be noted that all children screened at the schools suffered from gross tooth decay and many were living with swollen faces, due to acute abscesses.

On completion of the mission we treated over 450 patients and extracted over 650 teeth safely and with minimal discomfort. 3 individuals were also nominated for the dental therapist course.

Since writing this report Joseph has successfully continued to run the clinic. With my ongoing support and mentoring, Kamakwai will continue to have access to the dental unit in the district.

Eventually, as I continue to establish dental units in district hospitals around Sierra Leone, a network of therapists will be created. They will have access to customised resources that are in the process of being made available, as well as real time support from myself and other internationally based professional colleagues.

The ultimate goal is to have urgent dental services accessible throughout the entire country.